CORONARY-HEART-DISEASE RISK AND IMPAIRED GLUCOSE TOLERANCE The Whitehall Study

doi:10.1016/S0140-6736(80)92651-3

The Lancet

Volume 315, Issue 8183, 28 June 1980, Pages 1373-1376

https://doi.org/10.1016/S0140-6736(80)92651-3 Get rights and content

Abstract

In the Whitehall Study of 18 403 male civil servants aged 40-64 years, 71/2-year coronary-heart-disease (CHD) mortality has been examined in relation to blood-sugar concentration 2 h after a 50 g oral glucose load. CHD mortality was approximately doubled for subjects with impaired glucose tolerance (IGT), defined as a blood-sugar above the 95th centile (≽96 mg/dl). There was no trend of CHD mortality with blood-sugar below the 95th centile. Within the IGT group, age, systolic blood-pressure, and ECG abnormality (Whitehall criteria) were significantly predictive of subsequent CHD mortality. These findings are relevant to discussions on the criteria for diabetes which include the definition of an IGT category with increased risk of large-vessel disease, but without the high risk of small-vessel disease as occurs in diabetes mellitus.

References (23)

KM. West
Epidemiology of diabetes and its vascular lesions
(1978)
Jh Fuller et al.
Hyperglycemia and coronary heart disease: the Whitehall Study
J Chron Dis
(1979)
H. Keen et al.
Diabetes mellitus: a new look at diagnostic criteria
Diaberologia
(1979)
Dd Reid et al.
Cardiorespiratory disease and diabetes among middle-aged male civil servants: A study of screening and intervention
Lancet
(1974)
Dd Reid et al.
Smoking and other risk factors for coronary heart-disease in British civil servants
Lancet
(1976)
G. Rose et al.
Cardiovascular survey methods
WHO Monogr Ser
(1968)
G. Rose et al.
Prevalence and prognosis of electrocardiographic findings in middle-aged men
Br Heart J
(1978)
A. Amery et al.
Glucose intolerance during diuretic therapy: Results of trial by the European Working Party on Hypertension in the Elderly
Lancet
(1978)
Rj Jarrett et al.
Treatment of borderline diabetes. controlled trial using carbohydrate restriction and phenformin
Br Med J
(1977)

Sh Walker et al.

Estimation of the probability of an event as a function of several independent variables

Biometrika

(1967)

Cited by (727)

Cardiometabolic effects of sugars
2018, Medecine des Maladies Metaboliques
Les évènements cardiovasculaires restent une cause importante de mortalité prématurée. Des travaux épidémiologiques et expérimentaux chez l’homme et l’animal suggèrent que les sucres ajoutés, dont le fructose et le saccharose, peuvent majorer la pression artérielle, la fréquence cardiaque, le risque d’arythmie cardiaque, l’insulinorésistance, la stéatose hépatique, tout en favorisant l’inflexibilité métabolique cardiaque. Il serait important que les sociétés savantes se penchent sur la question des sucres ajoutés, d’autant que ceux-ci sont souvent associés à du sel en excès, dont le cumul pourrait augmenter le risque cardiovasculaire.
Cardiovascular disease remains one of the leading cause of premature mortality in the developed world. Evidence from epidemiological studies and experimental trials in animals and humans suggests that added sugars, particularly fructose, may increase blood pressure, increase heart rate and myocardial oxygen demand, increase the risk of cardiac arrhythmia, insulin resistance, and hepatic steatosis, and participate to the metabolic inflexibility in heart. It is time for guideline committees to focus more attention to added sugar, often associated with excess of salt in industrially processed foods. A reduction in the intake of added sugars, would help to the control of hypertension, hepatic steatosis, insulin resistance, and cardiovascular risk.
Overweight, the major determinant of metabolic syndrome among industrial workers in Kerala, India: Results of a cross-sectional study
2019, Diabetes and Metabolic Syndrome: Clinical Research and Reviews
To determine the prevalence and associated risk factors of metabolic syndrome (MS) among industrial workers in Kerala, India.
We measured fasting plasma glucose (FPG), triglycerides, high density lipoprotein cholesterol, waist circumference, systolic blood pressure and diastolic blood pressure among 2287 industrial workers (mean age 46 years, men 70%) from selected industries of two southern most Kerala districts using standard protocol in 2009. MS was defined according to international diabetes federation (IDF), Adult Treatment Panel (ATP-III) and American Heart Association(AHA)/National Heart Lung and Blood Institute (NHLBI) criteria (Harmonization). Age-standardized prevalence of MS was assessed for men and women. Multivariable logistic regression models were developed to find the associated factors of MS.
Age-standardized prevalence of MS was 14% (men 14%, women 15%), 19% (men 19%, women 21%) and 27% (men 30%, women 21%) as per IDF, ATP-III and Harmonization criteria respectively. Overweight adults were nine times (OR 9.41, 95% CI 7.34–12.06), twelve times (OR 11.80 CI 9.38–14.84), and four times (OR 3.56, CI 2.94–4.29) more likely to have MS compared to their counterparts according to IDF, ATP-III and Harmonization criteria respectively. Older adults and current alcohol users were more likely to have MS compared to their counterparts. Women were more likely to have MS as per IDF and ATP-III criteria.
MS prevalence was high among Industrial workers who generally have good access to health care. Overweight and other predictors of MS need to be addressed to reduce MS prevalence in this population.
Economic freedom improves income mobility: Evidence from Canadian provinces, 1982-2018
2022, Journal of Institutional Economics
Pros and cons of live kidney donation in prediabetics: A critical review and way forward
2024, World Journal of Transplantation
Short-term removal of exercise impairs glycemic control in older adults: A randomized trial
2023, Physiological Reports
Ten-year atherosclerosis cardiovascular disease (ASCVD) risk score and its components among an Iranian population: a cohort-based cross-sectional study
2022, BMC Cardiovascular Disorders

View all citing articles on Scopus

View full text

CORONARY-HEART-DISEASE RISK AND IMPAIRED GLUCOSE TOLERANCE The Whitehall Study

Abstract

Epidemiology of diabetes and its vascular lesions

Hyperglycemia and coronary heart disease: the Whitehall Study

J Chron Dis

Diabetes mellitus: a new look at diagnostic criteria

Diaberologia

Cardiorespiratory disease and diabetes among middle-aged male civil servants: A study of screening and intervention

Lancet

Smoking and other risk factors for coronary heart-disease in British civil servants

Lancet

Cardiovascular survey methods

WHO Monogr Ser

Prevalence and prognosis of electrocardiographic findings in middle-aged men

Br Heart J

Glucose intolerance during diuretic therapy: Results of trial by the European Working Party on Hypertension in the Elderly

Lancet

Treatment of borderline diabetes. controlled trial using carbohydrate restriction and phenformin

Br Med J

Estimation of the probability of an event as a function of several independent variables

Biometrika